Although it is uncommon in the U.S., stomach cancer is a serious, often devastating disease. An estimated 26,000 Americans are diagnosed with it each year, compared to about a million worldwide. But less than 25 percent of patients who are diagnosed with stomach cancer in the U.S. survive for five years. City of Hope’s physicians and scientists are committed to changing this.

“It is a deadly cancer among patients who are diagnosed with late-stage disease,” said world-renowned stomach cancer specialist, Yanghee Woo, M.D., who directs the Gastroenterology Minimally Invasive Therapy Program at City of Hope.

Early detection of stomach cancer is challenging due to a lack of specific symptoms.

“Eighty percent of our early-stage patients are asymptomatic or have symptoms that are nonspecific,” Woo explained. “For example, nausea, abdominal pain or discomfort, acid reflux or heartburn — these are all symptoms that you cannot attribute specifically to stomach cancer.”

Key symptoms include:

Significant weight loss

Persistent abdominal pain

Loss of appetite

Feeling full after eating very little

Feeling like something is getting stuck in your throat

However, these symptoms do not occur often, and they can persist for several months before the patient and/or doctor suspect a problem in the stomach.

Woo added that it is difficult to predict who will develop stomach cancer. Only 10 percent of cases have a genetic component, such as the BRCA1 and BRCA2 mutations. Risk factors include:

Being male. Men are twice as likely to get or be diagnosed with stomach cancer as women.

Being older. Most American stomach cancer patients are diagnosed during their late 60s.

Smoking.

Being of Asian-American, African-American or Hispanic-American heritage.

Long-standing infection with H. pylori bacteria.

“H. pylori is a bug that grows and lives in your stomach and can put you at anywhere between three to 12 times the risk of developing stomach cancer over time,” Woo explained.

Woo said that an upper endoscopy and biopsy are essential for diagnosing stomach cancer. When stomach cancer is suspected, a gastroenterologist inserts a scope into the esophagus via the mouth to check for abnormalities in the lining of the stomach. If an abnormality is found, then the doctor will perform a biopsy to test for cancer cells.

Breakthroughs in Treatment

Although a stomach cancer diagnosis can be very distressing for patients and their families, Woo said it is important for them to know that numerous treatment options are available. Stomach cancer that is confined to the inner lining of the stomach can be cured surgically, she said. Around 95 percent of these patients can live a normal life without cancer. Stomach cancer that has spread from the lining of the stomach wall to surrounding lymph nodes also is curable, “but at that point will require a multimodality treatment,” she added.

City of Hope is one of only a handful of hospitals in the U.S. that offers minimally invasive robotic surgery for stomach cancer patients.

An expert on this innovative treatment approach, Woo said it “allows for an early return to normal life, less blood loss during surgery, less pain after surgery and the ability to resume eating faster and go home sooner.”

City of Hope also is conducting a series of clinical trials that target stomach cancer proteins and harness the power of the body’s immune system.

One of the most exciting things that we are doing is conducting research into viral oncolytic treatments that target advanced gastric cancer and metastatic gastric cancer — diseases that have spread beyond the stomach into the peritoneum and the liver,” Woo said.

These treatments use viruses to modify the body’s immune cells so they can attack cancer cells. Although these studies currently are in the preclinical stage, she is hopeful that the treatments will be used to care for and cure stomach cancer patients within the next few years.

“This is the team-based model we promote at City of Hope,” she explained. “Each patient should be evaluated completely, and meet with not just the surgeon but also the medical oncologist, the radiation oncologist and key support staff to create a comprehensive treatment plan."